Dementia is a global challenge – a new report asks if anyone is ready to meet it?

A University of Birmingham report has concluded that national governments, health and social services, businesses, families and communities have to find new ways of responding to the rapidly growing number of people with dementia and of supporting the family and friends who care for them.

The University of Birmingham's School of Social Policy, who were commissioned by Walgreens Boots Alliance, produced a policy paper on the needs of the carers of people with dementia in different societies. Focusing on the UK, US, Norway, Australia and South Africa, the report explores the number and experience of carers with people with dementia in each setting, before moving on to review the research evidence and to identify good practice examples from interviews with leading policy makers, care-led organisations, public service leaders, voluntary organisations, businesses and academics.

Overall:

• This is a major challenge across the world, and all the signs show that different countries are not ready to face the consequences of these demographic changes
• Everyone will have a role to play in responding to these challenges – it cannot just be the responsibility of health and social services
• There could be advantages for businesses who can be sensitive to the needs of people with dementia and their carers – dementia affects a large group of potential customers and a large proportion of the workforce
• Support for carers can be patchy, and emotional and psychological support is often neglected
• We need to recognise the diversity of carers and caring situations – everyone is different and a 'one-size fits all' approach won't work

In response, the report calls for:

1. New research to focus not just on specific diseases, but also on the causes and nature of frailty itself. This should include the collection of clinical, biological, social and psychological data as people age in order to identify those most at risk of frailty (with dementia one of the conditions which people might develop) and target the drivers of frailty to develop new approaches to delay progression or even reverse frailty altogether.
2. Actions to help people recognise that they are 'carers' and to signpost existing sources of support. This needs to happen in everyday, community settings – not just in specialist health and social services. At present, too many people do not realise that the label of 'carer' applies to them, and so do not access support for carers.
3. Building advice and information into everyday life, so that people and families have greater scope to plan ahead. In the UK and in Norway, for example, new families receive a 'baby box' containing products for the baby and parenting information (sponsored by companies whose products are contained in the box). Mirroring this, there may be scope for what some of our participants described as "a care package" – a collection of information about the impacts of ageing (including early signs of dementia), financial planning for later life and available health and social services, which could be distributed to everyone at a particular age.

Elsewhere, the reports stresses:

• The importance of meeting the emotional and social needs of carers, alongside more tangible health and financial needs
• The need to recognise the diversity of carers and caring contexts, so that responses are tailored to individual needs and circumstances. Pressures can be particularly intense for the so-called 'sandwich generation', where someone who is middle-aged may be balancing caring for a parent with dementia with raising children and maintaining paid employment
• The need to provide more and better support, without assuming that carers continuing in their caring role is necessarily a good outcome
• The need to tackle stigma and social isolation, and to challenge cultural assumptions about the nature of care (for example, that families want to provide care for each other, that care is a mainly female responsibility and that some communities 'look after their own' more than others)
• The overriding importance of relationships – between the carer and the person being cared for, between members of local communities, and between the family and formal services.

Siân Thomas, a Lecturer in the Department of Social Work and Social Care at the University of Birmingham and someone who co-authored the report, said:

"Dementia is one of the biggest challenges facing us across the world, regardless of geographic location. So much of the responsibility for supporting people with dementia falls on their family and friends, and we need to do more to support these carers. Caring can often be a positive thing – caring for someone implies caring about them – but it can also place intolerable pressures on individuals and families if they aren't properly supported, and if they don't get a choice whether to become a 'carer' or not."

Richard Ellis, Vice President for Corporate Social Responsibility of Walgreens Boots Alliance, said:

"We're delighted to have commissioned this report, setting out one of the key health challenges facing us as a society, seeking to improve support for carers and helping to identify radical solutions. All of us have a role to play in making our communities better places to grow older – and the proposals set out here will help policy makers, employers, health and social services and society as a whole to reflect on what we need to do differently.